Briefing

What to know about COVID's seriously contagious BA.5 subvariant

Despite our most ardent wishes, the COVID-19 pandemic is "nowhere near over," World Health Organization director-general Tedros Adhanom Ghebreyesus said Tuesday. The current flavor of coronavirus spreading through the U.S. and much of the rest of the world is the Omicron strain's BA.5 subvariant, probably the most contagious version of the virus yet. Here's everything you need to know:

Where is BA.5 spreading?

"We can assume that it is everywhere because of the high transmissibility," Lin H. Chen, an associate professor at Harvard Medical School, tells The Washington Post. Even if it hasn't been reported or confirmed yet, "it is likely present already." 

The BA.5 subvariant has quickly become the dominant strain in the U.S., jumping from less than 10 percent of new COVID-19 cases in early June to nearly 80 percent of new cases by mid-July. New U.S. COVID-19 cases have risen to about 126,000 a day, and the weekly average of deaths and hospitalizations are up 7 percent, to 425 deaths a day, and 4 percent, respectively, according to Washington Post data

BA.5 and BA.4 collectively account for 69 percent of COVID-19 samples sequenced around the world, and the WHO said COVID-19 cases have tripled across its 53-nation European region over the past six weeks, accounting for nearly half of all global infections. "Anywhere it's detected, it's increasing at a faster rate than most other omicron variants that are around," said Andy Pekosz, a virologist at Johns Hopkins Bloomberg School of Public Health. 

And public health experts say for every reported case, 7 to 10 go unreported. "We're looking at probably close to a million new cases a day," Baylor College of Medicine's Dr. Peter Hotez told CNN. "This is a full-on BA.5 wave that we're experiencing this summer."

How worried should we be about this newly dominant variant?

The good news is that BA.5 "appears to cause less severe illness than its predecessors, although some people are still at risk, including those who are immunocompromised or over the age of 65," The Dallas Morning News reports. Hospitalizations are rising, but few of those patients are being sent to the intensive care unit or intubated. Hundreds of COVID-infected people are dying in the U.S. each day, compared to the 3,000 daily deaths the country experienced last winter.

The less good news is that BA.5's mutations make it much better at evading immunity protections conferred by vaccines and previous infections, helping it spread like wildfire. Some people who recovered from a different COVID-19 subvariant in March or April contracted the BA.5 strain in July. But vaccinations and treatments appear to be helping blunt more severe cases of the disease. 

"Most people have some underlying immunity that is helpful in fighting the virus," Johns Hopkins professor Dr. Anna Durbin tells NPR News. Because of that protection and antivirals, "we're not seeing a rise in deaths. And that's very reassuring. It tells me that even this virus, even BA.5, is not so divergent that it is escaping all arms of the immune system."

The rise in cases is still troubling for several reasons, including the elevated health risks and lingering symptoms that can result from one or more bouts of COVID-19. And even a mild case of COVID can make you feel lousy, Baylor College of Medicine's Dr. Thomas Giordano tells the Morning News. "As a clinician, I would say it's less severe, but as a person, I still don't want to get it because I don't want to be knocked out for a week with a flu-like illness."

What are BA.5's symptoms?

The symptoms appear to be similar to "the original Omicron strain, including headache, a sore throat, a runny nose, fever, and fatigue," the Morning News reports, and BA.5 is much less likely to rob your sense of taste and smell than the Alpha and Delta variants. 

At the same time, UC Davis Health says, "new research finds that with each repeat COVID infection — even asymptomatic infection — your risk for complications increases," including strokes, heart attacks, diabetes, and long-term cognitive impairment. 

Why don't the vaccines stop it?

Some key mutations in the BA.5 subvariant, especially on the spike protein it uses to breach healthy cells, make it harder for the body's immune system to detect, Dr. Jeff SoRelle at UT Southwestern Medical Center in Dallas tells the Morning News. Most immune systems eventually discover and attack the virus, he adds, but these mutations  "give it enough of a chance to sneak past the defenses and start causing some trouble."

Successful viruses evolve with the goal of replicating in cells, and BA.5 has proved particularly adept at vitality. "The high level of immunity in the population is likely exerting selection pressure on the virus and the virus is evolving to try to get around that immunity," Daniel Barouch, director of the Center for Virology and Vaccine Research at the Beth Israel Deaconess Medical Center, tells Vox

Are there ways to avoid getting infected (or reinfected)?

Yes, and they will sound pretty familiar two years into the pandemic: Stay up to date on recommended vaccine and booster shots, wear masks in public places where you will be in close proximity to crowds, favor outdoor activities, and isolate if you test positive or exhibit symptoms. 

Cloths masks reduce the risk of getting infected by about 50 percent, UC Davis Health reports, but you should "consider upgrading your face masks to N95s or KN95s if you want more protection." N95 masks cut the rate of infection by more than 80 percent.

"It's important to remember that you may be asymptomatic and not know you are infected but still able to spread COVID-19," UC Davis Health adds. "Wearing a mask in these situations helps protect vulnerable people you could unknowingly infect."

Should you get another shot now?

Current COVID-19 vaccines confer important protection against severe cases, but health officials and vaccine makers are planning to roll out vaccines and booster shots designed to fight off Omicron and its subvariants. But if you are eligible — kids older than 6 months can now get vaccinated and adults 50 years or older or immunocompromised can get a second booster shot — health officials and experts say it's a good idea to get inoculated now. You will be still eligible for the Omicron booster in the fall.

If you are 50 and older and "you've not gotten a vaccine shot this year, go get one now," Dr. Ashish Jha, coordinator for the White House COVID-19 Response Team, urged Tuesday. "It could save your life."

"I would go ahead and get it and not wait until the new versions of the vaccine are released, especially if you've got anything of significance that you're planning in the next two or three months like a trip or a wedding," Giordano tells the Morning News. "You don't want COVID to mess those plans up."

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